Performance of the crystalens hd iol
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Performance of the Crystalens HD ® IOL. Elizabeth Yeu, MD, Mariko Shirayama, MD, Quianta L. Moore, MD, Li Wang, MD, PhD, Douglas D. Koch, MD Cullen Eye Institute, Baylor College of Medicine Houston, TX. Purpose.

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Performance of the Crystalens HD ® IOL

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Performance of the Crystalens HD® IOL

Elizabeth Yeu, MD, Mariko Shirayama, MD,

Quianta L. Moore, MD, Li Wang, MD, PhD,

Douglas D. Koch, MD

Cullen Eye Institute, Baylor College of Medicine

Houston, TX


Purpose

  • To evaluate the visual performance of eyes implanted with the Crystalens HD® IOL as compared to the Acrysof® SN60WF IOL.


Methods

  • Prospective, non-randomized study that evaluated otherwise healthy pseudophakic eyes implanted with either the Crystalens HD or SN60WF IOLs

  • Invited to participate POD1 after uncomplicated phaco/PCIOL

  • Only 1 eye per patient was evaluated


Methods: POM1 and POM4-6

  • Parameters:

    • Uncorrected distance visual acuity (UCDVA)

    • Best-corrected distance visual acuity (BCDVA)

    • Distance-corrected near visual acuity: 40cm (DCNVA)

    • Amount of add-power required to read 1-over threshold

    • “Push-down” test x 3

    • Accommodative amplitude (AA) determined

      • 1/”push down” distance (cm)= value in D

      • AA= “Push down” – “Add” power @40cm

    • Pupil size: Neuroptics®pupillometer

    • Humphrey Atlas corneal topography


Methods

  • Corneal image quality was assessed via the Zernike Tool program (AMO), which calculated polychromatic modulation transfer function (PMTF) with Stiles-Crawford effect

    • PMTF at 15 cpd (20/40 object)

  • PMTF of corneal HOAs (3rd to 6th order, 4-mm pupil) from corneal topographic elevation data (Humphrey Atlas) were calculated


Effect of defocus on image quality

  • Defocus from -3 D to +3 D in 0.1 D intervals were added to the HOAs of the corneas

  • Depth of focus (DOF) was defined by 2 criteria


Depth of focus: Criteria

Peak value

DOF80

80% Peak

DOF50

50% Peak

  • Range over which the PMTF maintains 80% of maximum PMTF value (DOF80)

    • Changes in image quality are not noticed when the MTF maintains 80% of its optimal value

  • Range over which the PMTF maintains 50% of maximum PMTF value (DOF50)

    • DOF50 overcomes the disadvantage of the DOF80, in which eyes with higher peak PMTF values tend to drop faster

    • Hence, this range captures a greater defocus DOF while maintaining decent image quality


Results

  • POM 1:

    • 19 eyes Crystalens HD

    • 29 eyes SN60WF

  • POM4-6:

    • 9 Crystalens HD

    • 8 SN60WF


Results: POM 1

  • *Significantly different in AA and ** pupil size between groups (p<0.05); other comparisons p>0.05

  • No significant correlations seen between AA and pupil size


Results: POM 4-6

  • All pairs between groups (UCVA, BCDVA, DCNVA, AA and pupil size): p>0.05

  • *In SN60WF eyes, AA negatively correlated with pupil size (r= -0.84, p<0.05): Smaller pupil size strongly correlated with increased AA


DOF (D): mean ± SD (range)

  • No significant correlations between DOF and AA in all groups

  • No differences in HOAs and DOF between SN60WF and Crystalens (all P>0.05)


Crystalens HD IOL provides between an average of ~0.18 to ~0.85 D greater AA than SN60WF

No differences in corneal pseudoaccommodation account for AA

Additional AA from Crystalens HD from the IOL, but true flexing at the hinge vs. lenticularpseudoaccommodation is unclear

Conclusions


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